Investigation of licensed, registered or certified health care professionals and professionals in healthcare-related fields; unlicensed healthcare practice; prelicensure investigations; and compliance with provisions of the Uniform Credentialing Act, rules and regulations governing professional practice, and the Uniform Controlled Substances Act.
Mandatory reporting and complaint forms
You can fill out the form on-line then print and mail to the address below. Do NOT email complaints.For investigation information:
Email: Investigations.POL@dhhs.ne.gov
Do not email complaintsPhone: (402) 471-0175
Fax: (402) 471-6238Written complaints may be submitted to:
Michael Grutsch, PA-C
DHHS Division of Public Health Investigations
1033 O Street, Suite 500
Lincoln NE 68508
Due to their confidential nature, complaint allegations should NOT be sent via e-mail.
For more information about a profession or occupation and relevant statutes, rules and regulations, Licensing & Regulatory Affairs process, mandatory reporting, and Licensee Assistance Program go to Licensure Unit Page. For access to all Department statutes, rules and regulations, go to the Regulatory Analysis & Integration Page.
If you experience difficulty downloading these forms please be sure that you are using the most current version of Adobe Acrobat Reader which can be downloaded for free from Adobe Systems, Inc.
Reporting form used by Health Care Professional Reporting Another Health Care Professional
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Reporting form used by Health Care Facilities Reporting a Health Care Professional
Reporting form used by Insurers
Reporting form used by Health Facilities, Peer Review Organizations and Professional Associations
Reporting form used by Health Care Professional Self-Reporting Adverse Action
Nebraska Supplement for Insurers
What Needs to be Reported
What activities must be reported by a licensee, certificate holder, or registrant?
Every credentialed person who has first-hand knowledge of unlicensed, illegal or unethical activities is required to report (includes self-reporting) within 30 days of the occurrence. Failure to report may result in discipline. To view additional information relating to mandatory reporting, click on the options below:
Mandatory Reporting Forms Mandatory Reporting Summary (chart showing who is to report and what is to be reported)
Mandatory Reporting Regulations
Mandatory Reporting shall not apply:
- to the spouse of the person,
- to a practitioner who is providing treatment to such person in a practitioner-patient relationship concerning information obtained or discovered in the course of treatment unless the treating practitioner determines that the condition of the person may be of a nature which constitutes a danger to the public health and safety by the person's continued practice, or
- when a credentialed person who is chemically impaired enters the Licensee Assistance Program authorized by section
Neb. Rev. Stat. § 71-172.01 except as provided in such section.
How is a complaint reviewed, and what is the disciplinary process?
The following provides information relating to the complaint, investigative, and disciplinary process.
Overview of the Complaint Process
When your report is received, it will be carefully reviewed by the Department to determine if legal sufficiency exists to conduct an investigation. The law requires the Department to consider:
- Whether the complaint pertains to a matter within the authority of the department to investigate;
- Whether the circumstances indicate that the complaint has been filed in good faith and is not malicious, frivolous, or filed merely to annoy;
- Whether the complaint has been delayed too long to justify a present investigation;
- Whether the complainant is willing to be a witness and come forward to testify;
- Whether the information provided in the complaint, or within the complainant's knowledge, is sufficient to provide a reasonable basis to believe that the allegation, if substantiated by clear and convincing evidence, would result in discipline against the licensee; and
- Whether it is possible to secure necessary evidence from other sources.
The Department will notify you of the results of the review. The Department may also notify the subject of the complaint that a complaint has been filed.
Filing a complaint with the Department does not preclude you from privately pursuing legal remedies.
The Department does not arbitrate fee disputes, insurance or labor problems; does not investigate rudeness or personality conflicts. However, other agencies may be able to assist you if the Department is not able to act on your complaint.
- Office of the Attorney General-Consumer Protection (phone: 1-800-727-6432)
- Office of Dispute Resolution (phone: 402-471-3730)
A thorough and complete investigation by the Department will take considerable time and effort. When the department has determined that an investigation is complete, the investigator will prepare an investigative report for the appropriate professional board. After reviewing the report, the professional board will recommend a course of action to the office of the Attorney General.
The Attorney General reviews each investigation to determine if there is clear and convincing evidence that the subject of the complaint has violated statutes or rules and regulations. If there is clear and convincing evidence, the Attorney General may:
- Elect to file a petition with the Department to discipline the credentialed person;
- Negotiate a voluntary surrender or voluntary limitation of the credential;
- Enter into an assurance of compliance with the credentialed person in lieu of filing a petition;
Reports to the Department are confidential and investigation records are not public records. Any person making a report, except those self-reporting, is immune from criminal or civil liability for filing the report, or for disclosure of documents, records or other information to the Department.
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